Embedding the silver thread in all-age psychological services: training and supervising younger therapists to deliver CBT for anxiety or depression to older people with multi-morbidity

Abstract

Abstract Providers of cognitive behavioural therapy (CBT) in adult mental health services in the UK are expected to deliver therapy suitable for adults of all ages. However, older people commonly present with co-morbidities that challenge delivery of single-diagnosis CBT protocols. Added to this, the difference in age between therapy-provider and service-user can compromise collaboration. In this paper, I consider two key areas of relevance for training and supervising CBT therapists for work with older people, namely multi-morbidities and intergenerational relations. The evolving evidence base for CBT with older people is summarised and a commentary provided on previous ‘old age’ case studies from the Cognitive Behaviour Therapist (tCBT). Strategies for collaborative relationships are discussed, as are strategies for ‘embedding the silver thread’. I conclude with recommendations for future directions for CBT training and supervision. Key learning aims (1) To be aware that any differences in working with older people are not due to age per se, but factors such as cohort differences and multi-morbidity. (2) To reflect on case examples of CBT with older people. (3) To learn strategies for developing collaborative relationships across an intergenerational divide.